Permission to reprint the abstract has not been received from the publisher.

The number of obese Americans has sharply increased in the past 30 years. The typical American diet—which too often counts doughnuts and french fries as staples—is not what doctors and nutritionists would like it to be. Also, many of us do not exercise frequently enough. Our gluttony and sloth lead inexorably to bulging waistlines, chronic disease, missed workdays, high health-care costs, and premature death. To many minds, these problems suggest a first-order public health crisis.

Permission to reprint the abstract has not been received from the publisher.

Method: We developed the Stanford Childhood Obesity Projection
and Evaluation (SCOPE) model to simulate body mass index
(BMI) dynamics for children starting at age 2. The SCOPE model
follows children as they grow into adulthood, tracking their BMI
and obesity status. The SCOPE model projects outcomes including
BMI at ages 18 and 40, and diabetes and hypertension prevalence
at age 40. The parameters of the SCOPE model were informed
by nationally representative, longitudinal data: the National Health
and Nutrition Examination Survey (NHANES 2006), National
Longitudinal Survey of Youth (NLSY) Children and Young Adult
samples; and Panel Study of Income Dynamics (PSID). Using the
SCOPE model, we evaluated the following strategies: childhood
obesity screening (at age 5, 10, or 15) with interventions for children
at risk; and universal school-based obesity interventions
(e.g., interventions such as Planet Health).

Result: Without intervention, 33% of U.S. children currently
aged 5 through 10 will be overweight (BMI 25–30) or obese (BMI
≥30) by age 18. For obese 18 year-olds, the probability at age 40 of
being obese is 70%, of being diabetic is 23%, and of being hypertensive
is 39%. By contrast, for thin (BMI <25) 18 year-olds, the
probability of being obese is 24%, of being diabetic is 1%, and of
being hypertensive is 22%. Obesity screening in children under
10 misses more than 40% of those who become obese 18-year
olds. Screening at age 15 misses less than 15%. Universal schoolbased
interventions have greater health benefits than screeningguided
interventions, reducing the number of 40 year-olds with
BMI ≥30, diabetes, and hypertensions by as much as 1,000,000,
200,000, and 500,000, respectively.

Conclusion: Results from the SCOPE model support the role of
universal school-based interventions as promising tools to address
adult obesity-related illness compared to childhood obesity screening.
If universal interventions are infeasible, targeting obesity screening
in early teen years has a greater potential benefit than screening
for young children. Such interventions complement the continued
importance of obesity interventions during adulthood.

Permission to reprint the abstract has not been received from the publisher.

BACKGROUND: Evaluation of programs and policies to reduce the incidence of workplace injuries require that the consequences of injury are estimated correctly. Because workplace injuries are complex events, the availability of data that reflects this complexity is the largest obstacle to this estimation.

METHODS: We review the literature on the consequences of workplace injuries for both workers and employers, focusing on data sources, particularly linked administrative data from different public agencies. We also review other approaches to obtaining data to examine workplace injuries, including public-use longitudinal survey data, primary data collection, and linked employee-employer databases. We make suggestions for future research.

RESULTS: Recent advances in the literature on the economic consequences of workplace injuries for workers have been driven to a great extent by the availability of new data sources. Much remains unexplored. We find longitudinal survey databases including the National Longitudinal Survey of Youth, and the Health and Retirement Survey, to be very promising though largely untapped sources of data on workplace injuries. We also find that linked employee-employer databases are well suited for the study of consequences for employers.

CONCLUSIONS: We expect that new data sources should lead to rapid advances in our understanding of the economic consequences of workplace injuries for both workers and employers. Copyright 2001 Wiley-Liss, Inc.